经尿道膀胱肿瘤整块剜除术与经尿道膀胱肿瘤切除术治疗膀胱肿瘤的对照研究

Comparative analysis between transurethralen bloc enucleation by plasma and transurethral resection for the treatment of bladder tumor

目的探讨经尿道膀胱肿瘤整块剜除术(TUERBT)的疗效及安全性,并与经尿道膀胱肿瘤切除术(TURBT)做对照研究。方法选取2018年1月至2020年12月期间在新疆维吾尔自治区阿克苏地区新疆生产建设兵团第一师医院经临床诊断为膀胱肿瘤的患者60例,按随机数字法分为两组,其中行TUERBT患者30例,行TURBT患者30例,比较两组患者的手术时间、术中并发症的发生率、术后膀胱冲洗时间、术后留置导尿管时间、术后肿瘤复发等数据。结果TUERBT组平均手术时间长于TURBT组[(46.35±8.27)min vs(35.58±6.65)min,P<0.01],TUERBT组术中出血量明显低于TURBT组[(12.52±9.39)ml vs(24.46±11.58)ml,(P<0.01)],TUERBT组膀胱穿孔率低于TURBT组(10.08%vs 16.67%,P<0.05),两组患者术中闭孔反射发生率无显著差异(20.13%vs 16.67%,P>0.05);TUERBT组术后6个月肿瘤复发率低于TURBT组(3.33%vs 6.67%,P<0.05),TUERBT组术后1年肿瘤复发率低于TURBT组(10.00%vs 30.00%,P<0.05),差异有统计学意义。结论在新疆维吾尔自治区阿克苏地区新疆生产建设兵团第一师医院,TUERBT围手术期并发症发生率低于传统的TURBT,可以准确进行肿瘤分期,同时可以降低肿瘤复发率,该手术方式安全有效并值得临床推广。

Objective To compare the efficacy and safety between transurethral plasmid en bloc resection of bladder tumor(TUERBT)and traditional plasmid transurethral resection of bladder tumor(TURBT).Methods The participants were inpatients in the First Division Hospital of the Xinjiang Aksu Prefecture Xinjiang Production and Construction Corps from January 2018 to December 2020,and randomized divided into TUERBT group(n=30)and traditional TURBT group(n=30)by random digital method.The operation time,blood loss,obturator nerve reflex and bladder perforation were compared between the two groups.The recurrence rate of tumors at 3rd month,6th month,1st and 2nd year after operation were compared between the two groups.Results The average operation time of TUERBT group was significantly longer than that of TURBT group[(46.35±8.27)min vs(35.58±6.65)min,P<0.01].Intraoperative blood loss in TUERBT group was significantly less than that in TURBT group[(12.52±9.39)ml vs(24.46±11.58)ml,P<0.01)].The bladder perforation rate in TUERBT group was significantly lower than that in traditional TURBT group(10.08%vs 16.67%,P<0.05).The tumor recurrence rate of TUERBT group at 6th month was lower than that of TURBT group(3.33%vs 6.67%,P<0.05).The tumor recurrence rate at 1st year in TUERBT group was significantly lower than those in TURBT group(10.00%vs 30.00%,P<0.05).Conclusions In the First Division Hospital of Xinjiang Aksu Prefecture Xinjiang Production and Construction Corps,TUERBT has fewer perioperative complications than TURBT,and can accurately stage the tumor and reduce the recurrence rate.Thus TUERBT is accurate and worthy of clinical promotion.